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General NPI Number Information
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NPI Number | 1992887681
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Entity Type | Individual
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Provider Name | MELISSA BOWEN
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 02/09/2020
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Provider Practice Location Address
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Address Line | 500 ALA MOANA BLVD STE 7400
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City | HONOLULU
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State | HI
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Zip | 96813-4902
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Country | US
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Telephone | 858-395-9796
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 235371
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City | HONOLULU
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State | HI
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Zip | 96823-3506
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Country | US
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Telephone | 858-395-9796
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4305
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License Number State | HI
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